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A 53-year-old man develops acute, excruciating chest pain that radiates
to his back. En route to the emergency room, he becomes unresponsive,
and is pulseless on arrival. Resuscitation attempts are unsuccessful.
Autopsy reveals massive hemoperitoneum due to a ruptured aortic
dissection. There is a jagged intimal tear in the ascending aorta,
with a dissecting hematoma in the media, extending from the aortic
valve to the renal arteries. Which feature of this scenario most
strongly suggests hypertension as the cause of the aortic dissection?
A. Adventitial tear above renal arteries
B. Dissection through media
C. Involvement of major aortic branches
D. Origin at ascending aorta
E. Rapid exsanguination

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try again

ddd

aaaaaaaa

bbbbb

D. Hypertension is usually responsible for dissecting aneurysms located within 10 cm of the aortic valve. Patients present with sudden chest pain, which is usually severe and tearing in nature. The chronic hypertension causes a cystic medial necrosis, allowing the separation of vessel layers.

B. Dissection through media

b makes sense all the way

yeah B in my opinion is the right option coz its written in kaplan too that blood from the vessel lumen enters an intimal tear and dissects through layers of media that was the definition of aorotic dissection , the cause is the degeneration of cystic medial necrosis of tunica media ,
n predisposing factors are hypertension n marfans syndrome